Skin Cancer Treatment

Skin cancer is the most common type of cancer. Basal cell carcinoma and squamous cell carcinoma are the most common nonmelanoma skin cancers. Many are treated successfully with surgery, including excision or Mohs surgery. However, radiation therapy can be an excellent option when surgery may affect appearance, function, wound healing, or quality of life. Radiation can also be used after surgery when the pathology report shows high-risk features.

Skin cancer treatment should be considered more than tumor removal alone. Location matters. A small cancer on the nose, eyelid, ear, lip, scalp, or face can create a difficult surgical repair. Some patients are not ideal surgical candidates because of age, blood thinners, medical conditions, poor wound healing, or prior surgery in the same area. Others may need postoperative radiation when cancer cells are found at the margin, when the tumor has grown along nerves, or when the cancer is recurrent or aggressive.

At ROC, we use focused radiation techniques designed to treat the cancer while preserving as much normal tissue, appearance, and function as possible.

When Radiation Therapy May Be a Strong Option

Radiation may be recommended for:

• Basal cell carcinoma or squamous cell carcinoma in cosmetically sensitive areas
• Skin cancers on the nose, eyelid, lip, ear, scalp, or face
• Patients who are not good surgical candidates
• Patients who want to avoid complex reconstruction
• Tumors with positive or close surgical margins
• Perineural invasion, where cancer tracks along a nerve
• Recurrent skin cancer after prior treatment
• Larger or more aggressive tumors where postoperative treatment reduces recurrence risk
• Palliative treatment for bleeding, pain, or ulcerated tumors

Radiation is not the best choice for every skin cancer. Some lesions are still best treated surgically. The decision depends on tumor type, depth, size, location, pathology, prior treatment, and patient preference.

How the Procedure Works

Skin cancer radiation is often more superficial than radiation for deeper cancers. Depending on the tumor depth and location, we may use electron therapy or carefully planned external beam radiation.

Electrons are useful because they treat the skin and shallow tissues but do not travel deeply into the body. This helps protect deeper structures such as cartilage, bone, eye structures, salivary glands, and oral tissues. For certain areas, custom shielding may be used to protect nearby normal tissue.

Before treatment begins, the physician maps the visible tumor or surgical scar plus a safety margin. This margin is important because microscopic cancer cells can extend beyond what can be seen on the skin. A bolus material may be placed over the skin to make sure the radiation dose reaches the surface evenly. For curved areas such as the nose or ear, a custom setup may be used so treatment is accurate and reproducible.

Treatment is outpatient and painless. The patient does not feel radiation during delivery. Over the course of treatment, the skin reaction gradually builds, similar to a strong sunburn in the treated area. Healing continues after treatment ends.

Side Effects and How We Manage Them

Skin reactions are expected because the treatment is directed at the skin surface. Most are temporary and manageable.

Possible side effects may include:

• Redness in the treated area
• Dryness, peeling, itching, or tenderness
• Crusting or moist irritation as treatment progresses
• Temporary darkening or lightening of the skin
• Hair loss in the treated patch
• Swelling near sensitive areas such as the eyelid, lip, or ear
• Long-term skin thinning, firmness, visible small blood vessels, or pigment change
• Rare cartilage, wound-healing, or ulceration issues depending on location and dose

How we manage these effects:

• We provide skin care instructions before irritation becomes severe.
• We recommend gentle cleansing and avoidance of harsh soaps, fragrances, and scrubbing.
• We advise sun protection for the treated area during and after healing.
• We may prescribe topical medication if itching, inflammation, or moist peeling occurs.
• We use dressings or wound care support when needed.
• We design treatment fields to protect nearby structures such as the eye, cartilage, bone, and salivary glands.
• We schedule follow-ups to monitor healing and cosmetic outcome.
• We coordinate with dermatology, Mohs surgery, or plastic surgery when combined care is needed.

Call 847-698-0600 ext. 112 to schedule a consultation.